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15010083 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20541 STEVENS CREEK BLVD CONTRACTOR:ADIMPACT PERMIT NO: 15010083 OWNER'S NAME: CALIFORNIA BANK&TRUST 16620 ASTON ST DATE ISSUED:01/14/2015 OWNER'S PHONE: 8587937430 IRVINE,CA 92606 PHONE NO:(949)723-0187 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL l 1� CALIFORNIA BANK TRUST-INSTALL(2)WALL SIGNS License ClassG;;�v Lic.# Contractor o,7 LY -_'L Date/ I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the Valuation:$10000 performance of the work for which this permit is issued. Sq.Ft Floor Area: I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32634067 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITII N 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter 180 DAYS FR T CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Issued by: Date: 7 granting of this permit. Additionally,the applicant understands and will comply with all non-point source r ations per the Cupertino Municipal Code,Section 9 18. f �l RE-ROOFS: Signature Date ( �7 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ WNER-BUILDER DECLARATION Date: I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) am exclusive) contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property, Y g construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,;Secti �25525534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agen Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9 18. Signature Date SIGN PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �lJ CUPERTIN0 1 (408)777-3228• FAX(408)777-3333•building(G)cupertino.org C)S PROJECT ADDRESS ,, ` ?T7 APN# OWNER NAME (GPHrO✓gSg �7V V l E-MAIL �p STREET ADDRESS I'�ryI ,� CITY,STATE,Z FAX CONTACT NAME C� c7 PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT XCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME { �-�— LICENSE ER LICENSE, BUS.LIC# COMPANY NAME E-MAIL FAX 5u ti v-, STREET AqD S� CITY,STATE,ZIP / C PHONES ARCHITECT/ENGGrNEEiR NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OFWORK { `� S l�� Com/ `�Jj(/,ts'�- ✓� to USE OF ❑ SFD or Duplex ❑ Multi-Family ILLUMINATED SIGN TYPE NO.OF SIGN AREA VALUATION STRUCTURE: ❑ Commercial (Y/N) (CODE) SII^^G��NS (SQ.FT.) _ (S) SIGN TYPE CODES: L ® L D O 0 e B - BANNER SIGN M - MONUMENT(GROUND)SIGN BL - BLADE SIGN P - PROJECTING SIGN D - DEVELOPMENT ID SIGN SP - SPECIAL EVENT BANNER DI - DIRECTIONAL SIGN T -TEMPORARY E - ELECTRONIC W-WALL I READERBOARD WI -WINDOW SIGN D= ,, �1 £� TOTAL VALUATION x + x By my signature below,I certify to each of the following: I am the property owner or authorized ent t ct on the property owner's behalf. 1 have read this application and the information I have provided is correct. I have read the Description of Work an verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bui s tion. uthorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: //.—/3 —/V SUPPLEMENTAI(!F,OMATION REQUIRED Site Plan �I� CHFC117412�] s _ � uJrt��LIP" Elevations Sign Details-including UL listing(s)applicable s Y cPrANREv>� _Structural Calculations(if applicable) ® � o � _Copy of Planning Approval Letter or Meeting with Planning prior to r submittal of Building Permit application. , �, . . Rte`. .. �. ,: ... ..- � a... SignApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 20533 SCB DATE: 01/14/2015 REVIEWED BY: Mendez APN: BP#: *VALUATION: $10,000 *PERMIT TYPE: Building Permit PIAN('111"C'K 7111-1k'. PRIMARY PENTAMATION 1 CEAP5 USE. Sign PERMIT TYPE: i WORK California Bank Trust- install 2 wall signs SCOPE SIGN TYPE FEE ID QTY SIGN FEE Wall Sign,Electric 1SIGNWELEC 2 $572 TOTALS: $572.00 11 cit, Plan t r<.�k l'tumb T/an C.`hc�c1, nch Circuits 1 $48.00 GN Elec.Permit Fee: IEPERMIT Permit}r(w Plumb. ELL 11t7ter T'tumh 7rsn. r Elea Insp. 0.0 $48.00Pl urrb, hasp.l ee: Ira"", Pe"': NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the preliminaryinformation available and are onlyan estimate Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS 111un Check 1,ee: Suppl.PC Fee: Q Reg. ® OT 0.0 hrs $0.00 Permit Fee: $572.00 Suppl. Insp. Fee: Reg. I OT 0,0hrs $0.00 PME Unit Fee: $48.00 PME Permit Fee: $48.00 (.'onstruction Tax: T-7= "Llininfi,jr0livC PCW: Work Without Permit? ® Yes (F) No $0.00 Sign Master Plan: ® Yes (j) No $0.00 Travel Documentation Fee: ITRA VDOC $48.00 Strong-Motion Fee: IBSEISMICO $2.80 Select an Administrative Item Bld Stds Commission Fee: IBCBSC $1.00 r $719.80 $0.00 TONAL FEE: $719.80 .. Revised: 01/06/2015 N)�b- i 2)VL PLUS 2 WHITE 6500K SHORT WD OUT AT 30 MODULES PER FOOT,4.0"ON CENTER FOR DARK 4 � VINTL(ACRYLIC e 3)EACH MODULAR 60 POWER SUPPLY CAN RUN UP 1a 100 VL PLUS 2 WHITE 6500K SHORT MODULES Leclders t^ � 7e¢hnold 4)LAYOUT BASED ON A 5'CAN DEPTH SloanLED.conl/). !%;Tel 805.676.3260 5)DIMENSIONS ARE IN INCHES UNLESS STATED OTHERWISE Tall-free 888.747/1OL D<fax 805.,69,83206 /9 6)701269-6W5A2-MB WATTS PER MODULE-'.54 7)PRIMARY SYSTEM POWER:163.35 WATTS 8)LED MODULE POWER USAOE(axondary):130.68 WATTS V'jE P/S #1 P/S #2 P/S #3 .0 1 0. YN, RE` �U- ZA o12 9 7 12 10 13 15 1 15 15 -17 13 13 12 10 10 242 Modules x50 Lumens 12,100 lumens 71J.Ltd U wsk�� ESTIMATED PRODUCT B.O.M. PER SIGN: 1) This design and drawing are proprietary and the property of Sloaril Any reproduction or use without prior 242 Each VL Plus 2 White 6500K Short Modules - 97' written approval is prohibited. PN: 701269-6WSA2-MB 2) ChanneLED modules and power supply quantities are ESTIMATES ONLY and are based on the supplied 3 Each Modular 60 Power Supplies 12VDC information and drawings. Channel letter depth, lens color, material and;thickness can vary, which may bad to 1 Each 100' Roll of Jacketed Cable an increase or decrease in product at the time of installation. To ensure accurate product requirements, it is recommended that product is tested using customers specific lens material and letter configuration. 3) SloonLED highly recommends applying Light Enhancement Paint (LEP) 'or Ught Enhancement Film (LEF) inside at4ax DATENUleER AD IMPACT channel letters for optimal illumination. RA/ju 12/8/2014 30251 CALIFORNIA BANK &TRUST 4) Jacketed cable estimated assumes maximum run length of 15' per leg of the power supply. DATE PROJECTNAME CUENTAPPROVAL NO. DATE REVISION I An -11 Oi 12/16114 Add electrial notes per city request _ - __ z 10-10-14 CALIFORNIA BANK&TRUST _ __. ._ _ ..._. --.- - _. ` . 0 3 SCALE ADDRESS i a Shown 20533 Stevens Creek Blvd. PROPERrroWNERAPPROVAL ... .. . _. cITYISTATE * - - 16620 Aslan Street Irvine,CA 92606 V sRANcxs _.. CUPERTINO,CA (949)476-0015 tax(949)476-0029 PLOT PLANS CHECKED BY DATE lo-) F PL M"T VING DE T. IA-1 D AT'E HCOG. DEPT- C-OM�AIJMTY DEVF I 0prAL7:�, _T f.,7p,AR-7 BUILDING Di,ASi0N'-WFEIRTN"411) APPROV 0 KE;,. rh n;b� { fCc" Cs o X3 ) It i chflges or cl! 4L CALIFORNIA BANK TRUST . i. MIN CUPERTINO WFF� I,Ct COPY ,W,VA-7Vp Ll I ON 6/ - 2-051P STEVENS CREEK BLVD. CUPERTINO CA PREPARED BY: -2 0 Sa-3 ADIMPACT ` f A 'a 1 Parking lot > ..��. 72'-5" California Bank & Trust Existing Channel letters -South Elevation Existing Channel letters - North Elevation 1:Nf 9?i Stevens Creek Blvd f.) �p(g tfr }f1 vL,M. J 1Y 4 y '� 'X• SITE PIAN NTS e�1 Existing Mon pt SignVW ,`�,fla DATE -PROJECT NAME CLIENT APPROVAL NO. DATE REVISION r)tk. 10-10-14 CALIFORNIA BANK&TRUST � v i O SCALE ADDRESS t0v\0w ed V E 1■ 1 i -n Shown 2055.33 Stevens Creek Blvd. PROPERTY OWNER APPROVAL RANCH t1 cmnsTaTE 62 Aston Street in CA 92606 16 0 Irvine, dy (949)476-0015 tax (949)476-0029 CUPERTINO,CA t A 13 25-6" , F CENTERED NEW WITH EXISTING CALIFORNIA BANK 'TRUST: NORTH ELEVATION 5 DATE PROJECT NAME CLIENTAPPROVAL.. ... NO. ..DATE REVISION _.. 10-10-14 CALIFORNIA BANK&TRUST O W SCALE ADDRESS .:- _ _ .r l�'��Zd� •'� , as ii-i W. i -n A Shown 205533 Stevens Creek Blvd. PROPERTY OWNER APPROVAL - - e�\ �4•+ �b C� GA 92606 BRANCH# cmasTaTE9'e kCv��eO g`i t9 9)476-00156620 Aston �t2X (949)476-0029 CUPERTINO,CA ( A 25-6" NTERED NEW WITH EXISTING CALIFORNIA BANK TRUST` k {:i SOUTH ELEVATION cupFp'TjN0 n1 118" = 1'-0„ ��ildino D�Aattn► D .:DATE PROJECT,NAME CLIENT APPROVAL NO. DATE REVISION ._.. .. . m ” 10-10-14 CALIFORNIA BANK&TRUST , O SCALE ADDRESS .jm. SIM -n A Shown 20533 Stevens Creek Blvd. PROPERTY OWNER APPROVALrAy BRANCH# CITYISTATE 16520 Aston Street Irvine,CA 92605 CUPERTINO,CA (9491476-0015 fax.(949)476-0029 ' STATE OF CALIFORNIA - STATE OF CALIFORNIA SIGN LIGHTING CALIFORNIA ENERGY COMMISSION SIGN LIGHTING CALIFORNIA ENERGY COMMISSION CEC NRCC LTS o1-E Revised 06/14 NRCC-LTS-01-E CEC-NRCC-LTS-01-E Revised 06/14 NRCC-LTS-01-E CERTIFICATE OF COMPLIANCE (Page 2 of 5) CERTIFICATE OF COMPLIANCE (Page 1 of 5) Sign LightingDate Prepared:/ _/ Sign Lighting Date Prepared: Project Name: / i v l J l Project Name: �O n,� _ l -7\ 1 `` C •—_ - (..�• , Project Address: U 1b.Mandatory Sign Ughting Controls 2 � '3 � G/,rZs' 4 L If the person signing the Certificate of Compliance Declaration Statement o l this g quos ions: is responsible for complying with Outdoor Signs ❑Indoor Signs the sign lighting control requirements,that person shall answer all of the following questions: Location of Sign p Sign Alterations Phase of Sign Construction `New Signs g Type of Lighting Control ❑New Lighting Controls ❑Replaced Lighting Controls of Installing Lighting Controls If there are construction documents,indicate where on the building plans t e NA This Certificate of Compliance includes the following components(check all that apply) mandatory measures(sign lighting control)note block can be located: ❑Mandatory Measures Lighting Controls) ❑Maximum Allowed Lighting Power ❑Specific Lighting Sources 1 §130.3(a}l.All indoor sign lighting is controlled with an automatic time switch control or astronomical time- Y❑ N❑ switch control. §130.3(a)2A. All outdoor sign lighting is controlled with a photocontrol in addition to an automatic time- Y N❑ N❑A 2 switch control,or an astronomical time-switch control. ffMandatorySign Lighting Controls EXCEPTION to Section 130.3(a)2A:Outdoor signs in tunnels,and signs in large permanently covered outdoor Y❑ NA areas that are intended to be continuously lit,24 hours per day and 365 days per year. §130.3(a)2B. All outdoor sign lighting that is ON both day and night is controlled with a dimmer that provides responsible person may instal!both the sign lighting power and the sign lighting controls, or a different responsible the ability to automatically reduce sign lighting power by a minimum of 65 percent during nighttime hours. Y N NA y install the sign lighting controls than the responsible person installing the sign lighting power. controls,then the owner of the sign, 3 Signs that are illuminated at night and for more than 1 hour during daylight hours shall be considered ON both ❑ ❑ ' 2. The Mandatory Measures (sign fighting controls) are required for compliance with the sign lighting Standards. if the person responsible for installing the sign lighting power is not also responsible for the sign lighting day and night. general contractor,or architect shall ti responsible to have the sign fighting controls installed. EXCEPTION to Section 130.3(a)2B:Outdoor signs in tunnels and large covered areas that are intended to be Y N01 A 3. if more than one person has responsibility for compliance; each responsible person shall prepare and sign e Certificate of illuminated both day and night. §130.3(a)3. Demand Responsive Electronic Message Center Control.An Electronic Message Center(EMC) Y N N/A Compliance and an Installation Certificate applicable to the poriion of construction for which they are responsible;alternatively, having a new connected fighting power load greater than 15 kW has a control installed that is capable of ❑ ❑ the person with chief responsibility for construction shalt prepare and sign the Certificate of Compliance Declaration Statement 4 reducing the lighting power by a minimum of 30 percent when receiving a demand response signal. for the entire construction. Y NA la. Statements of Responsibility:Any person signing the Certificate of Compliance Declaration Statement on this NRCC-LTS-01-E EXCEPTION to Section 13Q.3(a)3•Lighting for EMCs that isnot permitted by a health or fife safety statute, ❑ iff shall complete Part 1a.Check Yes or No for all of the following statements: ordinance,or regulation to be reduced by 30 percent. I have responsibility for installing the sign lighting controls Field Inspector Notes: 1No,complete part 1a of this form ❑Yes,complete parts la and ib of this form There are no existing sign lighting controls and I will a installing compliant sign lighting controls 2 0 Yes someone elseNo will be responsible to install compliant sign lighting controls 3 There are no existing sign lighting controls and There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and §130.3 and I will be 4 installing compliant sign lighting controls ❑Yes o There are existing sign lighting controls that do not comply with the applicable provision of§110.9 and§130.3 and someone 5 else will be responsible to install compliant sign lighting controls ❑Yes �UPERTtN� �O(Jine DP a i80� 0OFCC)ii11P LI AN' Reviewed B\1 { (/ June 2014 CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014 CA Building Energy Efficiency Standards-2013 Nonresidential Compliance r • STATE OF CALIFORNIA STATE OF CALIFORNIA SIGN LIGHTING CALIFORNIA ENERGY COMMISSION SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 06/14 CEC-NRCGLTS-01-E Revised 06/14 CALIFORNIA ENERGY COMMISSION NRCC-LTS-01-E -E NRCC-LTS-01-E CERTIFICATE OF COMPLIANCE CERTIFICATE OF COMPLIANCE Sign Lighting (Page 4 of 5) (Pa e 3 of 5} 2 L ,f 13 I Date Prepared•, s C Sign Lighting Project Namc Date Prepared: G r�lJ '� � /V Project Name: 3.Speck Li>;htinlIt Source Method of Compliance 2.Maximum Allowed Ughtine Power Method of Compliance Certificate of Compliance and Field Inspection Energy Checklist Certificate of Compliance and Field Inspection Energy Checklist Complete this part if there are signs using the Specific lighting source method of compliance. (Complete part 2 of this Certificate Complete this part if there are signs using the maximum allowed lighting power method of compliance. omplete part 3 of of Compliance if there are signs using the maximum allowed lighting power method of compliance) this Certificate of Compliance if there are signs using the Specific lighting sources method of comp an ) A B C D E A B C D E F G H I J OPTIONAL—Energy Filed Inspector OPTIONAL Specific light source used for Field Inspector Symbol Complies Description of the Sign Verified Label(see Allotted watts Design wa YEN Check that sign Symbol ENERGY VERIFIED compliance Check that Sign Or Code instructions below) complies or Description label Shall include only lighting Complies U Code (see instructions technologies listed below Vol h below) List all that apply O v� ONg. w m z :// 07 - QNC y OO I NO CL O EL = Q O ❑ LU ❑ ✓ V ✓ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ A Symbol or code used on the plans(when plans are required)and other documents. ❑ ❑ B A narrative description of the sign,or location of sign on the building;and the location of sign on construction documents ❑ C OPTIONAL-Check this box only if this sign has a permanent,pre-printed,factory-installed ENERGY VERIFIED label,confirming that this sign 11 ❑ complies with the Section 140.8 of the California 2013 Title 24,Part 6 Standards,using the Specific Lighting Source Method of Compliance. The ❑ only labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by Underwriters Laboratories(UL)or 11 ❑ other Product Certification Body accredited to ISO/IEC Guide 65 by the American National Standards institute in accordance with ISO/IEC 17011.Surveillance by the Accredited Certification Body shall bean ongoing annual inspection program tamed out by a Type A Inspection body ❑ ❑ in accordance with I50/IEC 17020.For signs with such an ENERGY VERIFIED label,column'D'!s not required to be filled out.Note:Using an ❑ ❑ ENERGY VERIFIED label is an optional method to validate compliance.An ENERGY VERIFIED label is not needed for compliance. ❑ ❑ Specific Light Source Compliance Method. The sign(s)identified above use only the following lighting technologies: ❑ List all applicable numbers(1 through 9)that apply in column D above for each raw. 01 High pressure sodium lamps 11 ;Z1 13 Metal halide lamps that are pulse start or ceramic served by a ballast that has a minimum efficiency of 88 percent or ❑ ❑ 2 greater.Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage A Symbol or code used on the plans(whe tans are required)and other documents. when tested according to ANSI C82.6-2005. B A description of the sign,or location sign on the building;and the location of sign on construction documents. Metal halide lamps that are pulse start that are 320 watts or smaller,are net 250 watt or 175 watt(amps,and are serve y OPTIONAL-Check this box only if is sign has a permanent,pre-printed,factory-installed,ENERGY VERIFIED label,confirming that the 3 a ballast that has a minimum efficiency of 80 percent. sign complies with the Section 1 .8 of the Califonva 2013 Title 24,Part 6 Standards,using the Maximum Allowed Lighting Power Ballast efficiency is the measured output wattage to the lamp divided by the measured operating input wattage when tested method of compliance. The y labels that will be recognized for this purpose are ENERGY VERIFIED Certification Marks authorized by according to ANSI C82.6-2005. C Underwriters Laboratories L)or other Product Certification Body accredited to lS0/IEC Guide 65 by the American National Standards Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 75 percent Institute in accordance ISO/iEC 17011.Surveillance by the Accredited Certification Body shall be an ongoing annual inspection D 4 when the transformer or power supply rated output current is less than 50 mA.The ratio of the output wattage to the input wattage is at program carried out b a Type A Inspection body in accordance with I50/IEC 17020.For signs with such an ENERGY VERIFIED label, 100 percent tubing load. columns`D'throng I'are not required i o b filled out.Note:Using an ENERGY VERIFIED label is an optional method to validate Neon or cold cathode lamps with transformer or power supply efficiency greater than or equal to a minimum efficiency of 68 percent compliance.An ERGY VERIFIED label is not needed for compliance. 5 when the transformer or power supply rated output current is 50 mA or greater.The ratio of the output wattage to the input wattage is at D The sign area' square feet. Flu percent tubing load. E List"I"if t sign is internally illuminated. Ust"E"if the sign is externally illuminated. Fluorescent lighting systems meeting one of the following requirements:A.Use only lamps with a minimum color rendering index(CRI)of F AIlowe watts per square foot Enter 12 if the sign is listed as"!"in column E.Enter 2.3 if sign is listed as"E"in column E. 6 80;or B.Use only electronic ballasts with a fundamental output frequency not less than 20 kHz. G Mul ly the square footage in column D times the allowed Lighting Power Density(LPD=watts)in column F. 7 Light emitting diodes(LEDs)with a power supply having an efficiency of 80 percent or greater; H S w the total installed watts in the sign,as determined according to the applicable provisions of§130(c). Single voltage external power supplies that are designed to convert 120 volt AC input into lower voltage DC or tput,and have a i less than ore ual to the number in column G. Otherwise,the sign does not comply. 8 nameplate output power less than or equal to 250 watts,shall comply with the applicable regyj fgrnt�i�4ia a Efficiency nter Y if the number in column H s e q Regulations(Title 20). l V i naetl J This page doubles as a field inspection checklist g Compact fluorescent lamps that do not contain a medium screw b ;(E24/E26). A+++ i Field i pector Notes: E This page doubles as a field inspection checklist. , " Feld Inspector Notes: u ' CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014 CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014 ~ STATE OF CALIFORNIA SIGN LIGHTING CEC-NRCC-LTS-01-E Revised 06114 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE NRCC-LTS-01-E Sign Lighting (Page 5 of 5) Project Name: �— ` j. - .. Date Prepared. DOCUMENTATION AUTHOR'S DECLARATION STATEMENT - • 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentatio uthor Ame:r, Documentation A t - .� {� !//- Company. Signature Date: / Address: / �l�e5 _�,1 � -- CEA/HERS Certification Identification("rf applicable): j ` V J City/State/Z ,///', s / Phone: Q,' RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and cotrect 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer). 3. The energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Company: Date Signed: Address: license- city/State/Tp: Phone: CUPER INO N ttE�1EV -ooE�;o n 4eviewe'd �Y CA Building Energy Efficiency Standards-2013 Nonresidential Compliance June 2014